[Progressive hyperopia after radial keratotomy. A new etiological hypothesis: early keratoconus]

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Context:

• Preoperative assessment for refractive surgery routinely includes computer-assisted video-topography of the cornea.
• Early detection of keratoconus is crucial for patient outcomes.
• Historical data suggests a significant number of undetected early keratoconus cases were operated on in the past.

Purpose:

• To investigate the prevalence of early keratoconus in refractive surgery candidates using advanced corneal topography.
• To explore a potential correlation between early keratoconus and the long-term effects of radial keratotomy.
• To provide clinical, pathogenetic, and epidemiological evidence supporting the proposed correlation.

Summary:

• Computer-assisted video-topography identified early keratoconus in over 10% of pre-operative refractive surgery candidates.
• A potential correlation is suggested between early keratoconus and the increasing biomechanical effects of radial keratotomy.
• The hypothesis is supported by clinical observations, understanding of keratoconus pathogenesis, and radial keratotomy's mechanism of action.

Impact:

• Highlights the importance of advanced corneal topography in pre-refractive surgery screening.
• Suggests a need to re-evaluate the long-term safety and potential complications of radial keratotomy.
• Informs surgical planning and patient selection to mitigate risks associated with undiagnosed corneal conditions.